Felodipine reduces cardiac expression of IL-18 and perivascular fibrosis in fructose-fed rats.

Metabolic syndrome is associated with accelerated macrovascular and microvascular coronary disease, cardiomyopathy, and elevated inflammatory status. To determine whether metabolic syndrome-associated elevation of the inflammatory cytokine interleukin-18 (IL-18) in serum and cardiac tissue, and its potential sequelae could be attenuated pharmacologically, we studied fructose-fed rats. The fructose-fed rats exhibited increases in systolic blood pressure (SBP), body weight, heart weight, left ventricular weight, and blood insulin. Serum IL-18 levels in these rats were also elevated significantly. These changes were significantly different compared to those in control rats. Perivascular fibrosis around coronary arterioles was evident in the fructose-fed rats, accompanied by a paralleled increase in IL-18 by immunohistochemical analysis and real time polymerase chain reaction. Felodipine attenuated the increased levels in serum IL-18 and cardiac IL-18 mRNA as well as coronary perivascular fibrosis. Thus, augmented IL-18 in serum and cardiac tissue in metabolic syndrome may contribute to the coronary perivascular fibrosis; felodipine administration can attenuate the inflammatory and fibrosis process.

[The effects of antidepressant treatment on efficacy of antihypertensive therapy in elderly hypertension].

OBJECTIVE: To explore the effect of antidepressant treatment on antihypertensive therapy of senile hypertension. METHODS: 138 cases of senile hypertension complicating with depression were studied. 103 senile hypertensive patients without depression in the same period served as controls. The patients were randomly divided into 3 groups as A, B and C for study. 12.5 mg/d hydrochlorothiazide and 30 mg/d release-controlling tablets of nifedipine were orally administrated as basic antihypertensive medication each group. Besides, 20 mg/d fluoxetine was additionally given to groups A and one tablet of almitrine l/d and 20 mg oryzanol 3/d were given to group B. The treatment lasted 12 weeks. RESULTS: In comparison with pre-treatment, the blood pressure at base line in sitting position and the average circadian SBP and DBP monitored with 24-hour ambulatory blood pressure monitoring (ABPM) was remarkably decreased in group A with statistical significance (P < 0.01). These blood pressure parameters in group B were also decreased as compared ith the pretreatment level brt with less statistical significance (P > 0.05). It was also noted tha with the addition of antidepressant fluoxetine, the manifestations of depression ere alleviated as shown by Hamilton depression (HAMD) scale. untoward reactions such as nausea, perspiration and skin rash were noted in a few patients, but none withdrew from the study. CONCLUSIONS: Antidepressant and antianxiety treatment is of benefit to the antihypertensive therapy in senile hypertensive patients with complications of depression and/or anxiety neurosis. Based on the results of this study, it is suggested that routine administration of antidepressants and antianxiety drugs should be carried out in senile hypertensive patients complicating with depression or anxiety.